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Anyone dealing with PSOM?

HI,
My little three year old blenheim boy was diagnosed with mild SM when he was just a year old. He was rubbing, scratching his ears, hiding and fearful. I believed he was hard of hearing but I knew he could hear some sounds. Oh, I got him from a breeder at 6 months.

He was on gabapentin but I didn't see any difference in his behavior. Sometimes he would jump as if something stuck him and run and hid under the couch or chair. He would not come out even if I offered him a treat but I also noticed that he did not respond to his name or to basically anything.

He learned some hand signals but is petrified of anyone he does not know, children and other dogs. He will lie there and screem. I've had him to my regular vet who knows little to nothing about SM or PSOM. I suspect he has PSOM as he gags, yawns, gulps when swallowing as if his ears are clogged and scratches his ears constantly.

My vet checked him again yesterday and found no yeast or infection in his ears and no infection in his throat although he has very enlarged tonsils and lots of foam behind his throat. She says his eardrums are no longer shiny but dull. I'm taking him to a canine dermatologist Monday. They treat PSOM and check the ear with a scope. If it's found they do a small cut in each eardrum and suck out the glue like stuff clogged in the inner ear. I'm hoping that is what it is and after the procedure he might be able to hear.

Has anyone dealt with PSOM and if so has the treatment been successful. I feel so sorry for my little guy becaus I know that if you can't hear, your ears are clogged and you have problems swollowing you are really uncomfortable but he never cries out. He is so very stoic.

My Harley got SM but at first I always thought that he had PSOM. I am sure you can only diagnose PSOM through a scan and just looking with a scope will tell your vet absolutely nothing as PSOM sits behind the eardrum. I don’t know what a dermatologist can do but the procedure you are talking about should only be carried out by a vet as it has its risks. Also they shouldn’t JUST do the procedure if they are only guessing that it is PSOM . By who was he diagnosed with SM? A vet can only guess, you need to see a neurologist for both SM and PSOM.

Hi
When my Daisy had her full MRI she was diagnosed
with S M and PSOM but only in her right ear . So like
a lot of ladies she has selective hearing , we are treating
her S M but leaving her PSOM as it is.

Hello Kloey, my Ruby was diagnosed with sm in may, non symtomatic as this time, she was also told she had psom, through a scan, but i already suspected this, as she started to have hearing difficulty, she,s only six, but she is almost totally deaf, this was picked up on her scan, but i was advised not to seek surgery, because its likely to come back again, the specialist did say get a super sonic whistle. Rubys ears were very congested.But that is just one opinion,do some research into psom, and lots of advice, then you can make your own decisions. I felt this was right for me, as ruby has had to endure previous surgery, and they could,nt guarantee it would not return. Goodluck karen ruby and sadie

I found this on this on the Cavalier Health.org website: PSOM may be detected by veterinary neurology or dermatology specialists from either magnetic resonance imaging (MRI) or a computed tomography (CT) scan. http://www.cavalierhealth.org/psom.htm

There is a really interesting discussion on a previous thread, which might help.

Have you seen a neurologist rather than just a vet? As you have found, most vets really do not know much about any of these conditions and generally the recommendations for gabapentin given by neurologists like Dr Clare Rusbridge (do you/your vet have her treatment protocol?) are just starting doses that do need to be increased for many dogs, and it also generally takes more than simply gabapentin to manage the discomfort of these conditions. Usually it takes close work with a neurologist and trying various combinations of medications to find a good mix and then, that will generally need to be regularly reviewed and doses adjusted and medications dropped/changed. I have three with SM and my most-affected dog takes cimetidine and gabapentin and the dose of gabapentin has had to be increased regularly over time.

I would very strongly urge you to see a neurologist if you can, or have your vet speak to a neurologist familiar with this condition if it is impossible for you to directly see a board-certified neuro. All the symptoms you describe indicate a lot of pain and all are consistent with SM. I would guess that your cavalier most likely needs some additional meds such as a CSF inhibitor like cimetidine, probably an increase in the dose and/or number of times gabapentin is given, or try Lyrica as an alterative, and consider whether to add in an additional painkiller such as tramadol.

Personally, I would not proceed with exploring PSOM -- which is a lot less likely to be causing this pain -- if the pain has not yet been addressed with appropriate levels and types of medication. Generally most of the SM meds are used with PSOM. I would not even consider putting a dog thru a PSOM exam in its ears or the PSOM surgery if the SM is likely not to have been adequately addressed yet -- for an SM dog in pain, the exam could be excruciating and the surgery could cause even greater waves of pain.

There are some good neurologists in Florida -- check out www.cavalierhealth.org for a list. I would really make seeing a neuro your very top priority.

PS most of my dogs scanned for SM also had PSOM to some degree -- it is very common. Generally the surgery needs to be repeated at least once. Some dogs do get their hearing back but I would not do the surgery primarily for this goal -- deaf dogs do really well on hand signal (I have had two deaf cavaliers). One had PSOM and had this surgery and it made no difference at all to either his symptoms of PSOM or his hearing. He is deafer now than he was before the surgery. I'd have a dog BAER tested for hearing before doing a surgery to try and restore hearing -- to make sure the dog is actually deaf. A dog in pain would also likely be pretty unresponsive. Others BTW have had good success with restoring some hearing or stopping pain with the surgery -- but you'd really ant a neurologist to be sure the pain is not caused by SM, and that the deafness is not congenital -- which will take a scan to see whether he has significant buildup in his ears.

Good advice Karlin,surgery is not always the answer, you can get totally absorbed with the whole situation,but we are the responsible owners who love and care for our pets (family) and have to make decisions that are not easy.But as you said a lot of vets are not familiar with sm and psom, one vet i see earlier in the year had not heard of psom and i had to explain, i,ve learnt more from the forum, than i have from my vets, obviously the neurologist gave me guidance, then we have to act on it.Karen Ruby and Sadie

I think the myringotomy approach (surgery for PSOM) is REALLY helpful for some dogs -- for either hearing or discomfort/pain or both. BUT the literature notes it often has to be repeated at least once and this has been the case with almost every dog I am aware of that has had this surgery -- and it also doesn't always do anything, especially for deafness as there's a high rate of congenital deafness in the breed anyway (neither of my deaf cavaliers was deaf from PSOM). I've had advice from neurologists and vets not to do the surgery unless there's good reason to -- it does carry some risks of facial paralysis, though small, for example, so the benefits would need to be clear to me to opt for surgery. I was disappointed it did not do anything for Jaspar.

I really just wanted to underline that I would not start other explorations for cause of pain (especially probing in ears of a painful SM dog) if it is likely, as seems in this case, that SM is the cause of this pretty severe level of pain (hiding under tables and withdrawal indicates a lot of pain; many/most dogs will not cry out as it is basic instinct to hide pain, so it is not a good main indicator). Seeing a neurologist who knows the condition and working on getting medications right would be very urgent. Not least as the medications are pretty much the same for PSOM anyway if it is contributing to pain.

Having had two deaf dogs, I feel strongly that deafness alone is not a major issue for animals (nor people!). It is a moderately more challenging management task and requires responsibility of the owner to ensure a dog doesn't ever get in any risky area -- eg traffic -- when not on a lead, but dogs actually respond better and understand more clearly, hand signals over voice anyway. You can also get a small gently vibrating collar -- and teach a deaf dog recall using it, then out on that collar for walks (in safe areas) off-lead. My deaf dogs were/are so totally normal in 95% of their behaviour and interactions -- MORE attentive than the hearing dogs!! -- that I talk to them just like the others; I always forget they are deaf. PS I do add an extra tag which says "I am deaf. If you find me please put me on a lead right away and call my owner". In the Library section I have a post on deaf dogs and a link to some great online resources.